- In short: A government-commissioned report has found people with mental illness were subjected to compulsory treatments including seclusion, restraint and the use of induced comas.
- What's next? Six recommendations have been made to the Victorian government, including a political apology, and redress for patients and carers.
The Victorian government has been accused of trying to force changes to an independent report into the trauma caused by compulsory mental health treatment, with the author claiming he was threatened by department officials.
Last year mental health consultant Simon Katterl, who has lived experience, was contracted by the Department of Health to provide advice to the mental health minister about the impact of compulsory mental health treatments on patients.
The report found that Victorians who had suffered "gross human rights violations" during mental health treatment against their will should be offered financial redress by the state with a full public apology from the government.
Some people who had a mental illness were subjected to compulsory treatment that included seclusion, restraint and coercive treatment including the use of induced comas.
Author of report claims government demanded changes, made threats
The special report, commissioned by the department to provide advice to the mental health minister, has also called for Victoria to set up a restorative justice process.
This would allow consumers — people who were patients in the mental health system — and carers the chance to publicly detail the trauma they suffered as a result of treatment.
Mr Katterl released the report publicly on Tuesday morning.
"It's been a really taxing process, and it has really impacted me. But I just knew we had to have this conversation,'' he said.
He also accused the department of pressuring him to change the recommendations of his report, which he refused to do.
"A whole series of personal threats were made against me, to prevent me from releasing the report or to change the report,'' Mr Katterl said.
He said he was told he would not be considered for future work if he did not make changes the recommendations. He said the department was particularly concerned about the restorative justice process.
The state government has distanced itself from the report.
Premier Daniel Andrews said he had not read the report and directed questions to Mental Health Minister Gabrielle Williams.
Her office said it was a matter for the Department of Health.
The Department of Health said more work was required to explore options for acknowledging people's experience within the system.
The department did not address Mr Katterl's allegations.
In a statement, a department spokeswoman said following the royal commission into the mental health system, the department engaged with people with lived experience to better understand people's experiences within the system and harms caused to people.
"The department established an advisory group, involving people with lived experience and other relevant expertise, to consider options for acknowledging people's experiences,'' she said.
The contract with the Department of Health, signed last year in May, stated that the purpose of Mr Katterl's report was "to provide the Minister for Mental Health an options paper for acknowledging harm, stemming from the views of the lived experience community and best-practice evidence".
The report highlighted how people with mental illness were also harmed by the system through police violence, and killings and neglect by the community.
"On average, those within Victoria's mental health system may lose 30 years of life due to the medications they are forced to take. Some also die waiting for help. While detained, they may be sexually assaulted,'' the report said.
"Families, carers and supporters have lost people they cared for or watched them further harmed in criminal justice systems.
"Some have spent a lifetime on the precipice of disaster while trying to keep someone they love alive and safe. Collectively, these harms represent gross human rights violations."
The project was designed to find ways for the state to acknowledge the harm caused by the mental health system.
Acknowledging psychiatric harm
It made six major recommendations to the state government including a political apology, a guarantee the harms will not be repeated, as well as redress for consumers and carers.
The Victorian Mental Illness Awareness Council (VMIAC) and Tandem, which represents carers, were involved in shaping the report.
"This report signals the depth of pain that remains unresolved in our system, existentially affecting people with a lived experience as consumers and their family, carers and supporters,'' VMIAC chief executive Craig Wallace and Tandem chief executive Marie Piu said.
"The evidence behind these recommendations is strong, as is the moral case for them. These recommendations are both a challenge and an opportunity.
"They challenge the Victorian government, mental health services and practitioners to be curious about and confront the harms that arise from the system."
The report was released by the authors, not the state government.
Mr Katterl described the report as a world first.
"If the government took up our recommendations, it would be the first government in the world to act to formally acknowledge psychiatric harm," he said.
"The report was commissioned because as a sector and community, we're stuck. We know that the royal commission articulated a different mental health system, but we can't get there.
"Unacknowledged and misunderstood trauma is standing in the way. We can't move forward until we deal with our past and present."
Calls for restorative justice
In recent years, state and federal governments have made a series of apologies to communities harmed by past policies including the Stolen Generations and children abused in state care.
The report, written by a panel of people with lived experience of the mental health system, also called for a restorative justice process to be set up.
"Any acknowledgement of harm must be built on a deep understanding of that harm, informed by those most impacted,'' the report said.
Under the proposal, the new Wellbeing and Mental Health Commission — which is due to commence work on September 1 — would conduct a process that would allow people to publicly detail their poor experiences with the system.
"A restorative process that documents the harms is crucial to improve relations between those who use and administer the system, motivate cultural change in services, and reduce the prevalence of human rights violations," the report said.
The report also recommended the government consider individual and collective reparations.
"Mental health consumers and survivors as well as families, carers and supporters have suffered significant harm as a result of the mental health system (and interlinking systems that deal with mental health),'' the report said.
"These harms are physical, psychological, spiritual, and economic. Reparations or redress may be justified to compensate individuals and as a moral act of the state taking on responsibility for its failures."
The issue of harm was highlighted in the mental health royal commission, but lacked any truth-telling, the report said.
"This was valuable, but the trauma that envelopes the system and the people in it is unaddressed."
"It means we as Victorians have a vision of a better system, but little trust and shared commitment to get there. Impeding that future is the denial of these harms and the pain of those who have used the system."
Mental Health Carers Australia [MHCA], a peak body, said the report should be considered by governments all around Australia, not just in Victoria.
"A restorative justice process will provide families, carers and supporters an opportunity to share the harm they have endured in their interactions with the system and as a consequence of the system,'' MHCA CEO Katrina Armstrong said.
"Public apologies following a restorative justice process will not mark an end-point, but rather a beginning point, for mental health reform."
Shadow Mental Health Minister Emma Kealy said she was deeply concerned by the allegations.
"We need to make sure that everybody who suffered from any harm within Victoria's mental health system has their voice heard and is respected and recommendations are fully heard by the government," she said.
"Because unless we listen to the people who received harm, unless we listen to the people who know what we can do better, the system simply won't be reformed."
Greens MP Tim Read said his party supported calls for restorative justice.
"Properly conducted hearings will add meaning to a public apology from the government, for past abuses and mistreatment and the damage done to people who needed help,'' he said.
"A truth-telling process would help those with negative experiences of the system regain their trust in health workers and it would also help us plan for a future where restraint and seclusion are used less and less."
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